In order to detect the HLA antigenic differences between lymphocytes and granulocytes, the tests for cytotoxicity (CT) and agglutination (AT) were carried out by using various sera containing antibodies and separated lymphocytes or granulocytes. Reported here in Part I are the basic results obtained on the procedures themselves, i. e. for the CT and AT, and also for the cell fractionation.1) Both lymphocyte and granulocyte fractions could be obtained in sufficient quantity and quality by sedimentation in dextran and in conray 400 ficoll respectively.2) Iodoacetamide was not needed as an anticoagulant for the fractionation.3) The CT (LyCT for lymphocytes and GCT for granulocytes) were carried out using the NIH method; for the GCT, however, it was necessary to prolong the incubation time aft er mixing (serum, cells and complement) and subsequent statining time (for the dye exclu sion technique).4) As to complements, the home-refined complement was found to be best, but its titer fell easily. That obtained from the Hoechst Company was also useful, but the titer for the GC T had to be determined beforehand.5) Room temperature was found to be the most suitable for the GCT, and 37°C for the GAT.6) As to test sensitivity, the CTs were generally more sensitive than the ATs. The descending order of sensitivity was as follows: LyCT>LeAT (whole leucocyte agglutination test) >GAT = GCT>LyAT. The sensitivity of LeAT over GAT and LAT might be attributable to the cooperation of lymphocytes and granulocytes.

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Using the tests investigated in Part I, the HLA antigenic differences between lymphocytes and granulocytes were examined. Familly studies on HLA antigens, as well as studies using ALS (anti-lymphocytic serum) and AGS (anti-granulocytic serum) produced in rabbits were also carried out.
The results obtained were as follows:
1) In the HLA phenotypes and gene frequencies in lymphocytes obtained from persons originating from western Japan, little difference could be found from those already reported on the Japanese, but some rare types did appear in the lymphocytes of persons originating from the Kyushu district.
2) Antisera demonstrating good specificity were found for types A2, A3, A9, All, B5, B7, B12, B40, and BW22.
3) A coexistence of the A2, A9, B5, and B40 antigens was commonly found.
4) HLA antigens were also found in the granulocytes, but their assortments were different from those of the lymphocytes in each person.
5) Lymphocytes would often react to antisera in the CT even after their absorption with granulocytes. In the AT, however, the absorption was almost complete; i. e., the antigenic itic difference between lymphocytes and granulocytes could be detected by the CT, but not by the AT.
6) The family studies provided evidences on the hereditability of the HLA system.
7) As for the production of ALS and AGS in rabbits, no relationship could be found between the sera titers and the number of immunizations.
8) Of the rabbits' antisera not one was specific to the cell kind used for immunization; however, the use of these antisera in the LyCT, GCT, and LyAT, but not in the GAT, did suggest that the breadth of antigenicity was greater in lymphocytes than in granulocy tes.

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Tests for detection of leucocyte antibodies, i. e. the LyCT, LyAT, GCT, and GAT, were carried out using sera from persons with a history of blood transfusion, from pregnant women, and from delivery blood. Also the sera of blood donors were examined as to the existence of antibodies. Moreover, the relation between Ia antibodies and the GCT was also checked.
1) The relationships between the results of each pair of tests (CT/AT) were examined: The closest relationship was found between LyCT and LyAT, followed by LyAT and GA T, LyCT and GAT, LyAT and GCT, LyCT and GCT, GCT and GAT.
2) Granulocyte specific antibody was detected in some of the sera.
3) In twenty-two sera out of 47 antilymphocytic ones, the HLA types of the antibodies could be identified: the antibodies were those directed to the types frequent (more than 20% ) in the Japanese population, i. e. A2, A9, B5, B40, etc.
4) An attempt to group the granulocyte antibodies resulted, tentatively, in six groups. Some of the antisera showed high x2 values.
5) No GCT-positive sera could be found among the 300 blood donors.
6) So-called “Ia sera” were not GCT positive.
7) GCT was positive in 3.5% of the sera obtained from the delivery blood.
The results obtained in this tripartite study on the antigenicity of leu cocytes, especially that of granulocytes, may contribute to the safe and effective use of granulocyte transfusion, which is now becoming more and more frequently applied in clinical practice.

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Improvements in the management of the shock phase of severe burn and the development of topical agents for control of infection in the burn wound have significantly reduced the early post-burn mortality. Such advances have not, however, resulted in a dramatic overall decrease in mortality.
We underto ok an analysis of mortality and the many factors present on admission which we judged might influence mortality rates in our patients with severe burns. The study population consisted of the 14 burned patients, induced nine severe burns, from in-patient care at division of emergency medicine, kansai Medical University, during one year. After initial evaluation and emergency management, subsequent treatment included topical therapy, using porcine skin, silver salfadiazine cream, skin grafting as soon as possible, and occasionally early excision of third degree burns.
Five in 9 severe burned patients did not survive with acute renal failure or septicemia. Nine severe burned patients had significantly decreased RBC, Ht, platelet count and total protein within 7 days more than other patients, and many cases of severe burned patients had became hepatic faire, pulmonary damage and DIC.
In reviewing such factors in our patie nts, we think age, total burn area, third degree burn area, DIC, infection and multiorgan failure of pulmonary, liver and kidney as the factors present on admission which best distinguished survivors from non survivors.

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When isolated guinea-pig vas deferens was pretreated with 0.01% (w/v) tetrasodium edetate and then transferred to edetate-free sucrose medium, the addition of CaCl₂ (0.55-35.2mmol/l)induced a contraction in the preparation. The contraction was increased by the presence of MnCl₂( 0.005-0.01mmol/l) and suppressed by high concentration of the ions (1.0-5.0mmol/l); the contraction was, also, increased by MgCl₂ (0.01-0.1mmol/l) and suppressed by high concentration of the ions (10.0-20.0mmol/l).
When the preparation was kept in a sucrose medium without the edetate-pretreatment, CaC12 did not induce a contraction but KC1 (1.4-89.6mmol/l) did. The KC1-induced contraction was suppressed by MnC12 (0.005-0.5mmol/l) or MgC12 (0.1-10.0mmol/l) in a concentrationdependent manner; however, MgC12 (0.0lmmol/l) showed a tendency to increase the maximum contraction.
Noradrena line-induced contraction of the preparation kept in a Locke's solution was suppressed by MnC12 (0.1-1.0mmol/l) or MgCl₂ (10.0-20.0mmol/l), while increased by MgC12 (10.0-20.0mmol/l); MnCl₂ (0.1mmol/l) showed a tendency to increase the maximum contraction.
The CaC12-induced contraction is assumed to be a contracton caused by the influ x of calcium ions from medium into tissue and the KCl-induced contraction to be a contraction caused by release of tissue calcium ions. The influence of manganese and magnesium ions on the noradrenaline -induced contraction was tried to be explained from the influences of these ions on calcium- and potassium-induded contractions.

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The present author has studied the influences of haloperidol treatment in 22 schizophrenic patients electroencephalographically as well as psychopathologically. Of the 22 patients,17 were of paranoid form and five were of hebephrenic form, and all of them had been strictly free from any kind of CNS acting drug for at least one month prior to the present study. Their clinical evolutions throughout the treatment were recorded by the author in daily interview and evaluated by weekly scoring with the KMU edition of Expanded Brief Psychiatric Rating Scale (EBPRS). EEG was regularly examined during the treatment and recorded on magnetic tape for the quantitative analysis using Itil-Saito's method, which provides 22 EEG parameters representing 20 × 10 seconds' epochs as the time sample. The 22 parameters consist of ten frequency bands of primary waves, eight bands of first derivatives, mean values and standard deviations of primary wave frequency and amplitude. Based on the parameters, the author has studied their histograms of time sample EEG recorded before, three hours, one week and one month after the onset of treatment, and so-called t-profiles illustrating the changes from the base line (pre-treatment) EEG.
A controll study was don e in normal healthy male volunteers with single dose oral administration of haloperidol 0.75 and 2.25 mg, and it presented that haloperidol would induce a significant increase of 9.5-10.5 Hz alpha rhythm.
The patients' result was first examined in the form of group t-profile but the group t-profile without any significant change suggested the presence of induced EEG changes which are mutually contradictory. Actually, further examinations revealed a number of group differences as to patients' age, past history, incidence of alpha activity in base line EEG, clinical subdiagnosis, induced extrapyramidalism, and so forth. However, these group differences were finally found to be attributable to none of the above-mentioned items, but to the general improvement scores of patients' clinical features. In the groups of which the majority showed a marked clinical improvement, a significant increase of moderate alpha activity was presented, while in the groups of which the majority did not show any noticeable improvement, the increases of fast and/or slow activity due to a decrease of alpha rhythm in the contrary. The former group consited of those who were in their thirties to forties of a shorter history, less than 40% in alpha incidence, paranoid, within two weeks from the onset of extrapyramidalism, and the latter one consisted of those who were in their twenties, longer than five years in history, more than 40% in alpha incidence, hebephrenic, over two weeks from the onset of extrapyramidalism and free from any extrapyramidal disorders. These results have been confirmed by the comparison of t-profiles of the therapy responsive patients and those of the therapy resistant ones.
The increase of alpha activity which was seen in normal volunteer study seems to correspond with the normalization of EEG and also with the exertion of pharmacological influence of haloperidol. The increases of fast and slow activities seen in the patients who were not clinically improved can be interpreted as the increase of the deviation from normal EEG possibly due to the lack of their functional elasticity. The differences of the EEG changes induced during the haloperidol treatment were found to be neither influenced by the daily dose nor by the accumulated dose of halloperidol, but maily by the clinical outcomes of the patients.
The EEG changes can be seen already in the three hours postdrug recording and the author has convinced that it is quite possible to predict the patient's outcome at a high probability early after the first single administration of haloperidol solely based upon the quantitative analysis of patient's EEG.

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Though there are many cases demanding oxygen therapy among newborn babies with acute respiratory distress, experimental studies on oxygen toxicity to the lung by using newborn animals have been scarcely reported, Fine structural changes of the lung in newborn rats under high oxygen environment were studied by an electronmicroscope.
Soon after delivery, newborn rats were raised in chamber of 80% o xygen concentration with their mothers. The newborn rats were sacrificed daily up to 1 week. On the other hand, one group of newborn rats brought up in the high oxygen chamber for 1 week was replaced to room air and they were studied at 2 and 4 weeks after the replacement, respectively, and the following results were obtained.1) The most predom inant change observed was an interstitial edema in the alveolar septum, acomypanying with interstitial proliferations later. This change was irreversible as long as 4weeks.
2) The change of, swelling and edematous destruction observed in basementmembrane was another marked change in the alveolar septum.
3) The capillary endothelial cell show ed increase of electron density, and irregularity of cell surface and increase of pinocytosis. Those changes recovered completely after 4 weeks under room air environment.
4) Bo th increase of electron density and projection of type I epithelial cells into alveolar cavity are also noticed on type I alveolar epithels as minor changes which recovered easily under room air environment.
5) The abov e mentioned findings were similar to the histological changes observed in prolonged respiratory distress syndrome (PRDS) or/and bronchopulmonary dysplasia As these findings were obtained by high oxygen environment without IPPV, high oxygen environment is likely to be one of pulmonary edemagenic agents, that is to say, oxygen: toxicity can be the major cause of BPD not only in premature infants but also in mature infants.

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A patient,77 years old male, who underwent partial gasterectomy due to gastric cancer at cardia (histologically: well-differentiated papillary adenocarcinoma (Photo.4), showing lymph node metastasis) in Dec.,1976, noticed one small tumor in his left supraclavicular region one and a half year thereafter, which had grown rapidly up to 5.0 x 5.5cm in Nov.,1978.
Laboratory examinations (Tab.1, Fig.1) revealed anemia (249 x 104/mm3, mac rocytic normochromic)and polyclonal hypergammaglobulinemia (2.4g/dl,4O), although no plasma cell was found in his peripheral blood.
As the biopsies of this tum or, carried out twice, showed a picture of non-specific chronic inflammation of the lymphnodi remarkably infiltrated with mature plasma cells (Photo.1), no tumor cells being found, it was difficult to rule out the plasma-cell type of Castleman's lymphoma.
The bone marrow picture of the patient showed a slightly increased percentage of plasma cells.
Gastroscopy and X-ray examination of the bones revealed no abnormalities. Because this tumor had continuously extended into the medi astinum, exstirpation could not be done; and anticancer drugs were not used, as no cancer cells were found anywhere.
Thus, radiation and steroid therapies were performed against the plasma cell proliferation and hypergammaglobulinemia, resulting a decrease of the tumor size and a descent of the serum gammaglobulin level. But, after these therapies were stopped because of melena and decreased lymphocyte number, the tumor size began to increase again, the serum gammaglobulin level elevating up to 4.0g/dl (56 %) (Fig.1).
The patient expired due to chachexia at the end of March,1979.
The autopsy revealed in the tumor, considered to be swol len Virchow's node (Photo.2), undifferentiated carcinoma cells (Photo.3), probably originated from the gastric cancer previously resected, were found surrounded by immense plasma cell and lymphocyte proliferation.
As to the interpretation of the cytological difference found between the cells of the primary focus and those of the Virchow's node, i. e. well-differentiated papillary adenocarcinoma and undifferentiated carcinoma respectively, the former cells might have been transformed into the latter through the influence of the anticancer drugs administered after the operation or that of the host immunity, or only the undifferentiated ones among the cancer cells existed in the primary focus might have metastasized.
Besides, no carcinoma cell was found in the residual gastrium and, in the bone marrow, plasmacytosis was seen (Photo.5).
The intensive plasma cell infiltra t ion concomitant with the metastatic cancer cells seen in the Virchow's node, the bone marrow plasmacytosis, and the hypergammaglobulinemia observed in this case could be interpreted as the signs of the immune response occurred in the cancer bearing host.
Further, induction of plasmacytoma could be expected, if the immune stimulation as seen in this case persisted for a longer term.

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Seventy-two year old Japanese man had complained of severe cough and dyspnea and was sent to our hospital to examine the abnormal shadow found in the X-ray photograph of right chest. Although he was generally well after the admission, thoracocentasis was done 1 - 2 times a week to remove pain and drosy of the right chest. By the repeated cytologic examinations of hemorrhagic thoracic fluids, Class IV: adenocarcinoma was suspected. Subcutaneous tumor was detected in the right anterior breast 4 months after his admission. The materials of 4 times biopsies from the subcutaneous tumor were diagnosed for pulmonary adenocarcinoma, malignant mesothelioma or fibrosarcoma, and hyaluronic acid could not be proved in the biopsy specimens. He died of hematoemesis 16 months after his first complaint about the chest. On autopsy, diffuse malignant mesothelioma of biphasic histological patterns was localized in the rigth pleura, in which the tumor appeared diffuse thickening and made a large cystic space lined by the tumor-infiltrating visceral and parietal pleuras. The space contained a gelatinous fluid and intracystic papillomatous growths of the tumor. Multiple nodular tumorinfiltrations progressed into the right breast including subcutaneous tissue, right diaphragma, right lung and pericardium. Both disseminations in the peritoneal cavity and hematogenous metastasis to the left lung and lumbar vertebra were also detected. Both histochemical detection of hyaluronic acid in the tumor cells and their specific ultrastructures indicated that the tumor originated from the mesothelial cells.

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